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ST. JOSEPH, Mo. — If you go to the doctor for low back pain, you probably expect a prescription. But when people go to a doctor in St. Joseph, they get something else.

Marsha Steele’s lower back has been hurting a lot. She’s at six to eight on the pain scale. Steele was prescribed medicine, including a narcotic, at the emergency room. It’s the standard way doctors treat pain in America, but Dr. Vikas Agarwal thinks that’s wrong.

“Has that helped our people? Has that reduced the chronic pain in our population? No,” Dr. Agarwal said .

He sais he began looking for other approaches. The internist with Mosaic Life Care, formerly Heartland Health, came upon the McKenzie Method.

“Stand straight. Put your hands here,” he says as he has Steele lean back.

More than 50 years old, McKenzie is used by some physical therapists but not by doctors in the primary care setting. Dr. Agarwal argues it should be there, heading off chronic problems. It emphasizes posture and simple movements.

“It seems so simple. It’s like why didn’t I know to do it this way,” Steele said.

Dr. Agarwal says McKenzie is aimed at improving body mechanics.

“The majority of acute pain is actually mechanical pain, and if you remove the mechanics, the pain disappears right away,” he said.

Steele’s pain level after 20 minutes of practice?

“I’m a happy camper. Uh, 2,” she tells the doctor.

Steele will need to repeat the exercises every few hours.

“I’m gonna have to do them because it’s too painful not to,” she said.

After several months of doing them for his low back pain, Delbert Weddle is a believer.

“Night and day, truly. I am able to — I feel no pain at all now,” he said.

Dr. Agarwal says the toughest sell with other doctors since our system of treating pain and getting paid for it revolves around imaging, pills, injections and surgery. He says with McKenzie, patients are empowered to treat their own pain.

“They don’t have to come to the doctor’s office. They are not dependent on me,” he said.

He says he’s happy giving them a book with exercises instead of a prescription. He adds that McKenzie won’t work for all types of pain, certainly not cancer pain.